Treatments for thyroid cancer

If you have thyroid cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for thyroid cancer, your healthcare team will consider:

the type of thyroid cancer

the stage

the risk group

your age

your personal preferences

You may be offered one or more of the following treatments for thyroid cancer.

Surgery

Surgery is the first treatment done for most thyroid cancers. Depending on the type, stage, risk group and location of the cancer, you may have one or more of the following types of surgery.

Lobectomy removes one side, or lobe, of the thyroid. It may be done for low-risk differentiated thyroid cancer (papillary or follicular carcinoma) or anaplastic carcinoma when the tumour is small and only in the thyroid.

Total thyroidectomy completely removes the thyroid. It is the most common type of surgery done for thyroid cancer.

Neck dissection removes lymph nodes from the neck. Other tissues around the thyroid may also be removed. Neck dissection is usually done when cancer has spread to lymph nodes in the neck. It is done at the same time as a total thyroidectomy.

En bloc resection removes the tumour and surrounding tissues, lymph nodes and structures in the neck as one piece (en bloc). It may be done for anaplastic carcinoma when the cancer has spread outside the thyroid to tissues and structures in the neck.

Surgery for metastasis may be used in rare cases to remove thyroid cancer that has spread, or metastasized, to distant organs such as the lungs, bone, brain or liver.

Palliative surgery is used to relieve symptoms. It may be done to remove a large tumour. It may also be used to remove as much cancer as possible (called debulking). For example, the surgeon may remove cancer that is blocking an airway or pressing on the spinal cord.

Tracheostomy is a surgical procedure to create an opening (called a stoma) in the trachea through the neck so air can reach the lungs. It is needed when cancer presses on or blocks the trachea (windpipe) and makes it difficult to breathe.

Hormonal therapy

Hormonal therapy with the drug levothyroxine (Synthroid, Eltroxin) is standard treatment after a total thyroidectomy. It is used to replace the hormone thyroxine, which would normally be made by the thyroid. It is also used to slow down the growth of any remaining differentiated thyroid cancer cells and help lower the risk of a recurrence.

Radiation therapy

Radiation therapy is a common treatment for many thyroid cancers. It is most often used after surgery to kill any cancer cells and normal thyroid tissue that remain in the body, and treat cancer that has spread to lymph nodes or other parts of the body. It may be used as a palliative treatment if the cancer can’t be removed with surgery (it is unresectable) or thyroid cancer has spread to other parts of the body and is causing symptoms.

Radioactive iodine therapy is the most common type of radiation therapy used. It is often used for differentiated thyroid cancers that are large or have spread outside the thyroid. It is also given for most poorly differentiated carcinomas.

External beam radiation therapy may be used for thyroid cancer that doesn’t absorb, or take up, iodine. This includes anaplastic and medullary carcinomas.

Targeted therapy

Targeted therapy may be used to treat advanced or metastatic differentiated thyroid cancer when radioactive iodine therapy hasn’t worked or has stopped working. It is also used for medullary carcinoma that comes back, or recurs, after other treatments.

Targeted therapy drugs used to treat thyroid cancer include:

sorafenib (Nexavar) for differentiated thyroid cancer

lenvatinib (Lenvima) for differentiated thyroid cancer

vandetanib (Caprelsa) for medullary carcinoma

Chemotherapy

Chemotherapy is not used very often for thyroid cancer. It may be used to:

help relieve or control symptoms of advanced or metastatic thyroid cancer (called palliative chemotherapy)

treat anaplastic carcinoma, sometimes as part of chemoradiationchemoradiationTreatment that combines chemotherapy with radiation therapy. Chemotherapy is given during the same time period as radiation therapy. Each treatment makes the other more effective.

Chemotherapy drugs used to treat thyroid cancer, either alone or in combination, include:

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better rather than treat the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Follow-up care

Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, usually for at least 10 years after treatment has finished. These visits allow your healthcare team to monitor your progress and recovery from treatment.

Clinical trials

Some clinical trials in Canada are open to people with thyroid cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.